Constellation School Based Therapy, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

CONSTELLATION SCHOOL BASED THERAPY, LLC

Practice address

14 Westport Ave
Norwalk, CT 06851-3915

Phone

(203) 663-6771

NPI assigned

Jun 24, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jason Alan Creutzmann

Title

Administrator

Phone

(203) 663-6771

Specialties & licenses 3

Addresses

Electronic endpoints 1

Interoperability endpoints

• Direct secure messaging: adminschools@constellationhs.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561334400000",
    "number": "1124689922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068513915",
            "telephone_number": "203-663-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068513915",
            "telephone_number": "203-663-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTELLATION SCHOOL BASED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2019-06-24",
        "status": "A",
        "authorized_official_last_name": "CREUTZMANN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "203-663-6771"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Adminschools@constellationhs.com",
            "affiliation": "N",
            "address_1": "14 Westport Ave",
            "city": "Norwalk",
            "state": "CT",
            "country_code": "US",
            "postal_code": "068513915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Connecticut Renaissance, Inc.
• Deborah Michele Connelly, D.C.
• Craig Stephen Conoscenti, MD
• Conquer Physical Therapy LLC
• Constellation Home Care LLC
• Liane Conte, DO
• Amanda Nicole Conti, PA-C
• Sandra L Contreras Martinez
• Kathleen D Conway, APRN, BC, CS
• Stephanie Coogan

• Behavior Analyst in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Behavior Analyst in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.